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COLUMBUS, Ohio – That classmate who appears to avoid speaking up in class and misses social functions could be experiencing more than shyness. Up to one in seven Americans, including many adolescents, suffer from social anxiety disorder – a condition that can be so intense that its emotional symptoms are accompanied by a number of physical responses as well.

Also called social phobia, the condition is the third most common psychiatric disorder, and yet “most people think it’s rare and has an insignificant effect on people’s lives. The reality is it causes significant disability and impairment,” said Dr. Radu Saveanu, executive director of OSU Harding Behavioral Healthcare and Medicine.

The disorder is characterized by an intense, unreasonable fear of being embarrassed or humiliated. Physical responses may include blushing, palpitations, trembling, shortness of breath, dizziness, and sometimes nausea and diarrhea. Sufferers tend to either avoid social interactions or situations in which their performance will be monitored or “endure them with distress,” said Saveanu, also chair of psychiatry in The Ohio State University College of Medicine and Public Health.

For teen-agers, the school setting can be scary territory: Being called on in class or getting together with friends “become occasions to be scrutinized or to be embarrassed,” Saveanu said. “Kids with social phobia tend not to do well in school. They don’t raise their hands, they don’t speak in class and they don’t want to participate in group projects. If the disorder isn’t identified and treated, these tendencies in youth can translate into social and professional impairment in adult life.”

Parents who might be inclined to push their children who show signs of social phobia should do so with caution. “A little push is OK. But kids with social anxiety disorder are really not trying to be disruptive or disobedient,” he said. “Parents should understand the limitations these children have; criticism could make them even more fearful.”

Saveanu said effective treatments for social phobia include psychotherapy to help sufferers develop coping skills when anxiety surfaces and a number of medications, most common among them the newer anti-depressants.

One of the most vexing elements of the disorder may be reaching the decision to seek help.

“Many people with social phobia don’t seek treatment. They think if they had a tougher constitution, they’d be able to overcome their fears,” Saveanu said. “A lot of these adolescents who don’t seek treatment will generally have a lower socioeconomic status as adults because they are unable to live up to their professional potential. Identifying problems early really avoids a lot of subsequent issues.

"It’s most important to realize that social phobia is not a weakness. It is a psychiatric condition that requires attention.”

OSU Harding Behavioral Healthcare and Medicine, part of the Ohio State University Medical Center, serves the central Ohio community with behavioral health services for children, adolescents and adults, including treatment for anxiety and panic attacks, depression, post-traumatic disorders, family and marital conduct, personality disorders, schizophrenia and sexual abuse.

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